Buteyko for the Reversal of Chronic Hyperventilation

What is Chronic Hyperventilation Syndrome?

Chronic Hyperventilation Syndrome (CHVS) is a vast complex of bizarre29,31,16protean1,29,31,18 symptoms and disorders that are caused by habitually breathing too much. Technically it is not a syndrome at all since the symptoms are so variable. Not withstanding that chronic hyperventilation (CHV) has a compelling appeal as the physiological basis for the many chronic disorders we see

today, mainstream medicine has consistently failed to deal with it since its discovery over 100 years ago.1,16,18,24,29

In 1975 British cardiologist, Claude Lum wrote:16

Some forty years ago Kerr, Dalton and Gliebe wrote “Patients presenting the well-known pattern of symptoms haunt the offices of physicians and specialists in every field of medical practice. They are often shunted from one physician to another, and the sins of commission inflicted upon them fill many black pages in our book of achievement.”

Unfortunately I believe this to be still true today, despite the many and excellent reviews which have appeared in the intervening years.

The millennium has rolled over and, despite the astonishing results seen in the clinical trials2,6,19,20,21,25 on Buteyko for asthma, Chronic Hyperventilation Syndrome (CHVS) has still received no recognition from mainstream medicine.

How does Chronic Hyperventilation (CHV) develop?

Chronic hyperventilation develops from any chronic, un-discharged stress on the body including elements of western lifestyle, leading to a depletion of carbon dioxide (CO2) and bicarbonate (HCO3–). 14,16

The respiratory centre, situated in the brain stem, paces breathing in order to maintain pH according to the Henderson-Hasselbach equation:

Hence, to maintain pH, the ratio of CO2 to bicarbonate in the cerebro-spinal fluid (CSF) needs to remain constant. Since the blood-brain barrier is extremely permeable to CO2, this is readily accomplished by regulation of breathing.10 If the body is stressed, breathing increases, CO2 is reduced and a state of alkalosis develops. If this stress is sustained, the kidneys compensate by dumping bicarbonate in order to reestablish normal pH in the blood.10,16 However, the blood brain barrier is only very slightly permeable to bicarbonate resulting in a very slow diffusion of bicarbonate from the cerebro-spinal fluid (CSF) into the blood10if the stress is sustained for a very long time (chronic stress). When the stress eventually dissipates, the cerebro-spinal fluid (CSF) is left with a low bicarbonate concentration.10,16 To maintain pH the CO2 will also have to be kept low and a habituation to low CO2 will have taken place.14 The resulting low CO2 and bicarbonate has a devastating effect on all significant biochemical processes. 7,14,16,18,24, 29

How does Buteyko therapy work?

Buteyko therapy is a simple educational programme aimed at reversing chronic hyperventilation (CHV). In the same way as chronic stress leads to CHV, so too a deliberate reduction in breathing over a period of time reverses this process to restore CO2 back to a normal level.

“The essence of my method is in decreasing the depth of breathing. You would ask me how. The best way is through relaxation of the muscles that potentiate the breathing action. What then occurs is a sensation of having insufficient air if the breathing is reduced. These are all the instructions – the whole of the method.” - K.P. Buteyko.4

What happens to patients with Chronic Hyperventilation Syndrome(CHVS)?

Consider the following population distribution for arterial carbon dioxide. The normal range is between 35 and 45mmHg. Most people could be expected to fall into this range. Those who fall below this range but are not acutely hypocapnic, do not have hypocapnia recognized as the possible cause of their disease by mainstream medicine. 1,16,18,24,29

Physiological consequences of low CO2.

1. Poor oxygenation of tissues due to a depressed Bohr effect.5,7,18,29,31 Once oxygen attaches itself to the hemoglobin in the lungs, it is transported to the tissues where it is needed. CO2 is necessary to fully off load the Oxygen into the tissues. When the baseline level of CO2 is too low, the oxygen is not fully unloaded resulting in tissue hypoxia. The consequence is a feeling of breathlessness, which aggravates the condition, frequent yawning and sighing, build up of acids, such as lactic acid, in the body and joints leading to fatigueability,16,18,31,30 exhaustion5 and pain in muscles5,16,18 and joints.

2. Muscle spasms.5,7,16,24,29Since calcium transport across the cell membrane involves CO2, hypocapnia results in a redistribution of Calcium, which tends to accumulate inside the cells leaving the extra cellular fluid depleted.24 This directly affects the ability of smooth muscle to relax.11 Hence, hyperventilation is associated with spasms in smooth muscle, resulting in dysfunctional gut motility as in spastic colon24, and irritable bowel syndrome,24 spasm in the bronchioles as seen in asthma,5,7,12,16,24,29 spasm in arterioles5,7,16,24,29,31 resulting in hypertension24 and ischemia,24 as well as spasm in glands and ducts. In addition, esophageal spasm can result in dysphagia,5,165,16,30,31 Globus Hystericus and together with spasms in the diaphragm and sphincter, various degrees of hiatus hernia24 may develop with associated gastric reflux. Hypoxia due to a depressed Bohr effect together with ischemia can produce angina,24 headaches,16 migraines5,24 and syncope.5,7,16

3. Profound biochemical derangements caused by chronic hyperventilation include: hypophosphatemia,18,29,31 elevated lipids,24 elevated sugar levels24 and elevated lactic16 and uric acid24 apart from disturbances to calcium homeostasis.CO2 is directly involved in all biosynthetic processes including the biosynthesis of amino acids, nitrogenous bases, fats and carbohydrates.14 It is also involved in stimulating the production of hormones such as insulin.14 It also

stimulates the production of gastric secretions.14

CO2 affects the production of acetylcholine in nervous tissue and the excitability of nerves.5,14,31 High CO2 tends to have a calming effect on the nervous system, while low CO2 causes increased sympathetic tone,16,18,29,30,31 decreased parasympathetic tone,5 paresthesia and numbness,1,5,7,16,18,24,29 twitching eyelids,16 visual and auditory disturbances,5,7,16,29,31 seizures and fits,7,16,29 tremors and shaking,5,16,30 ECG and EEG abnormalities.7,24,29,30

Immune System

Particularly vulnerable is the immune system, a finely tuned biological warfare mechanism responsible for identifying, differentiating and destroying pathogenic invaders. Disturbances to the biochemical environment in which the immune system has to function can be expected to lead to variable forms of immune system failure.

As a result the system may over react to pollens or other non-pathogenic invaders. It may fail to deal effectively with bacteria and viruses and could even attack the body’s own cells as in autoimmune diseases such as arthritis, diabetes, and multiple sclerosis. The immune system is also responsible for recognizing and removing cancer cells. It should come as no surprize that post-traumatic, post-viral, post-partum and psychological stresses can lead to major failures of the immune system.

Other Symptoms and disorders

Chronic hyperventilation affects every organ, body part and system.16 The protean nature of the symptoms makes this disorder particularly insidious. The symptoms that will manifest in an individual depend mainly on genetic predisposition. Asthmatics, for example, have bronchioles that are particularly efficient at closing up whenever the lungs are hyperventilated.

Apart from the symptoms already discussed, the mainstream medical literature provides us with an astonishing array of symptoms directly attributable to chronic hyperventilation (CHV). For example:

It is also known that K.P. Buteyko worked on the role of hyperventilation in addictive behaviours such as alcoholism and drug dependency.

Buteyko for Asthma

With over 40 years of experience in treating patients with chronic hyperventilation (CHV) disorders in the USSR, Dr. K.P. Buteyko confirmed the observations of Kerr, Dalton and Gliebe in the 1930’s, that CHV developed mainly from life style.17

For example, he found that in children, the three most important reasons for developing asthma and other hyperventilation disorders are: 151. Over feeding. 2. Over heating (too much clothing, too many blankets from over protective parenting) 3. Too little physical activity.

Theory

Bronchospasm results directly from low alveolar CO2

Inflammatory hyper responsiveness due to malfunctioning immune system (see Immune system above)

Results after 12 Weeks

1. Medication used

Bronchodilators reduced by 96%

Steroids reduced by 49%

2. Minute Volume and ETCO2

ETCO2

Buteyko

Control

Normal

Before

33

32

41

After

35

33

MV

Buteyko

Control

Normal

Before

14.0

14.2

11.9

After

9.6

13.3

• Asthmatics have significantly lower ETCO2 than normals • Minute volume significantly reduced in Buteyko group • Increase in ETCO2 in Buteyko group statistically NOT significant • Reduction in medication use found to be proportional to reduction in minute volume

3. Quality of Life and Symptom Score9 • Improvement in Quality of Life

Lung Function Test

At this stage the sole impediment to acceptance of the Buteyko method for dealing with asthma appears to be the lack of improvement in lung function. But this argument is flawed on 3 levels.

1. There was no reduction in lung function not withstanding the significant reduction in medication. 2. According to Buteyko’s hyperventilation theory, bronchospasm is not a disease, but a natural reaction by the body to hyperventilation. It just so happens that asthmatics have lungs that perform this function particularly well. 3. The test itself affects the variable being measured by constricting the bronchioles during the hyperventilation manoeuvre. 5,31,8 Measurement science invalidates this type of testing.